This thesis considers parental psychological well-being and the acceptability of parenting support for those who have an adolescent with type one diabetes (T1D). Within the literature it is acknowledged that T1D diagnosis and management can have an effect on all family members. Furthermore poor parental well-being can impact negatively on adolescent well-being. It is therefore important to understand parental well-being in the context of adolescent T1D. Paper one presents a literature review of the psychological status of parents of adolescents with T1D. The review highlighted that adolescent T1D diagnosis has the potential to impact on parental psychological well-being, with some parents experiencing clinically concerning symptoms of anxiety, depression or psychological distress at different time points during their adolescent’s chronic illness. Over recent years it has increasingly been recognised that psychosocial variables can impact on physical well-being and illness management. It is important that individuals who experience distress are offered appropriate support. With regard to families and parents, psychological support may be offered through parenting interventions. Paper two aimed to explore whether Teen Triple P Positive Parenting Programme resources were acceptable to parents of adolescents with T1D and whether they would be interested in undertaking a parenting intervention. It also explored whether adolescent behaviour difficulties, parental psychological distress or diabetes-related family conflict were related to parents’ acceptability ratings and intentions to participate. Diabetes factors, such as time since diagnosis and levels of blood glucose control were also considered. The results indicated that the Teen Triple P resources have the potential to be acceptable to parents and that they would be interested in participating in a parenting intervention if one was available to them. The critical reflection considers both the literature review and the scientific study. Within this paper the approaches used, the challenges encountered, and the implications for clinical practice, and future research, are considered.

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"Diabetes mellitus" refers to a spectrum of conditions, which all present with hyperglycaemia as a common medical finding. Diabetes was once thought of as a single disease, but according to Setter et a/. (2000:378), it includes a heterogeneous group of disorders that are secondary to various genetic predispositions and precipitating factors. Type 1 diabetes mellitus (DM) accounts for 10 to 15% of all cases of diabetes mellitus and is clinically characterised by hyperglycaemia and a propensity to diabetic keto-acidosis. Its control requires chronic insulin treatment. Although it may occur at any age, it most commonly develops in childhood or adolescence and is the predominant type of diabetes mellitus diagnosed before age 30 (Beers & Berkow, 2004). Type 2 DM is usually the type diagnosed in patients older than 30 years of age. It is also commonly associated with obesity (Berkow, 1992:1108). The objective of this study was to review the usage and cost of antidiabetic drugs and to determine the influence of the pricing regulations on the cost of these drugs. This research can be classified as retrospective and quantitative. Data were obtained from a prescription claims database, and the study population consisted of all the antidiabetic prescriptions for the year 1 January 2004 to 31 December 2004. The one-year period was divided into three study periods, namely January to April, May to August and September to December. Firstly diabetes mellitus was investigated in order to understand the disease and to determine the prevalence and treatment thereof. It was found that diabetes mellitus is a heterogeneous disorder acquired from both genetic and environmental factors and that education for the general population, and in particular for the patients, is the key to preventing and controlling diabetes and reducing the complications arising from it. Secondly managed health care, pharmaco-economics and a drug utilisation review were investigated in order to understand these concepts. The influence of the South African Government on health care was discussed, including the new pricing regulations of medicine in South Africa. Thirdly, the utilisation patterns of antidiabetic drugs were reviewed, analysed and interpreted. It was determined that the oral antidiabetic agents are relatively less expensive than the insulins and that they are prescribed more frequently, and secondly that the biguanides presented almost half (49.4%, n = 116 138) of all the oral antidiabetic agents. It was also determined that the average cost of the oral antidiabetic drugs was between 21 .O% and 28.0% lower in 2004 than in 1996 - an indication that, despite inflation, the antidiabetic drugs were less expensive in 2004 than eight years ago in 1996. It was also calculated that the total cost savings in antidiabetic medication could have been R1 448 682.26 if the lower price of antidiabetic agents had been implemented during the period January to April. And finally it was also determined that further substantial "cost savings" could have been possible if all the innovator antidiabetic products had been substituted for less expensive generic antidiabetic products. Abstract / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2006.

"Diabetes mellitus" refers to a spectrum of conditions, which all present with hyperglycaemia as a common medical finding. Diabetes was once thought of as a single disease, but according to Setter et a/. (2000:378), it includes a heterogeneous group of disorders that are secondary to various genetic predispositions and precipitating factors. Type 1 diabetes mellitus (DM) accounts for 10 to 15% of all cases of diabetes mellitus and is clinically characterised by hyperglycaemia and a propensity to diabetic keto-acidosis. Its control requires chronic insulin treatment. Although it may occur at any age, it most commonly develops in childhood or adolescence and is the predominant type of diabetes mellitus diagnosed before age 30 (Beers & Berkow, 2004). Type 2 DM is usually the type diagnosed in patients older than 30 years of age. It is also commonly associated with obesity (Berkow, 1992:1108). The objective of this study was to review the usage and cost of antidiabetic drugs and to determine the influence of the pricing regulations on the cost of these drugs. This research can be classified as retrospective and quantitative. Data were obtained from a prescription claims database, and the study population consisted of all the antidiabetic prescriptions for the year 1 January 2004 to 31 December 2004. The one-year period was divided into three study periods, namely January to April, May to August and September to December. Firstly diabetes mellitus was investigated in order to understand the disease and to determine the prevalence and treatment thereof. It was found that diabetes mellitus is a heterogeneous disorder acquired from both genetic and environmental factors and that education for the general population, and in particular for the patients, is the key to preventing and controlling diabetes and reducing the complications arising from it. Secondly managed health care, pharmaco-economics and a drug utilisation review were investigated in order to understand these concepts. The influence of the South African Government on health care was discussed, including the new pricing regulations of medicine in South Africa. Thirdly, the utilisation patterns of antidiabetic drugs were reviewed, analysed and interpreted. It was determined that the oral antidiabetic agents are relatively less expensive than the insulins and that they are prescribed more frequently, and secondly that the biguanides presented almost half (49.4%, n = 116 138) of all the oral antidiabetic agents. It was also determined that the average cost of the oral antidiabetic drugs was between 21 .O% and 28.0% lower in 2004 than in 1996 - an indication that, despite inflation, the antidiabetic drugs were less expensive in 2004 than eight years ago in 1996. It was also calculated that the total cost savings in antidiabetic medication could have been R1 448 682.26 if the lower price of antidiabetic agents had been implemented during the period January to April. And finally it was also determined that further substantial "cost savings" could have been possible if all the innovator antidiabetic products had been substituted for less expensive generic antidiabetic products. Abstract / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2006.

This thesis, entitled The Specific Needs of a Child with Type 1 Diabetes Mellitus in Primary School, is divided into two main parts. The theoretical part deals with the disease of diabetes mellitus, mainly type 1 diabetes mellitus and the specifics of childhood diabetes. In the practical part I focus on identifying the specific needs of children with type 1 diabetes mellitus attending the first level of primary school. Research information was obtained through interviews with parents of these children. The aim of the research was also to determine the level of satisfaction of parents with the schools' approach and whether and what they would like to change about the schools' approach. According to the responses, all school staff should know that a child is diabetic and be able to help them with hypoglycaemia. The child should be able to tell their classmates about the illness, respond to glycaemia at any time and contact parents if necessary. A negative experience associated with diabetes in the school environment was reported by 6 out of 15 children. In contrast, the same number of parents were satisfied with the approach and found nothing they wished to change. Parents would like teachers to be more empathetic and better educated. As a didactic output, an educational lecture was developed for...